Shortly before reading about this article on the BBC News Website, my
partner had described to me her visit, the previous day, to one of the
nursing homes we cover. We have been getting a very large number of
requests from this home for night sedation and similar drugs, and she
commented that she had thought that the staff were going to barricade the
doors to prevent her leaving until she had prescribed the requested items.
A receptionist has also told me that a staff member from the home had
hinted that they would complain to the PCT if I did not prescribe as
asked.
It seems that GPs cannot win here, and refusals are met by much
wailing and gnashing of teeth and heart-rending tales of vulnerable
insomniac residents.
On a wider scale, however, I wonder why it is worthy of comment that
patients who require nursing home care are on more medication than their
peers who are managing a more independant existence, and why this fact
should be taken as a sign of inadequate care. It was not even clear
whether we GPs are over-or-under prescribing. I am sure there are up-to-
date figures for the proportion of Care-of-Elderly admissions which are
iatrogenic, and if you wanted to draw up a rogues gallery of responsible
drugs, I am sure that beta-blockers and aspirin would not be left out.
I attempt, with very limited time, and against often competing
interests, to tailor my care to the individual circumstances of my
patients, and to resist the pressure to reduce them to a list of tick-
boxes. To take another swipe, it appears that if I wish to increase, or
even maintain my income if the New Contract does come in, that I will face
ever more such pressure.
Competing interests:
GP struggling with Nursing Home demands
Rapid Response:
Damned if we do....?
Shortly before reading about this article on the BBC News Website, my
partner had described to me her visit, the previous day, to one of the
nursing homes we cover. We have been getting a very large number of
requests from this home for night sedation and similar drugs, and she
commented that she had thought that the staff were going to barricade the
doors to prevent her leaving until she had prescribed the requested items.
A receptionist has also told me that a staff member from the home had
hinted that they would complain to the PCT if I did not prescribe as
asked.
It seems that GPs cannot win here, and refusals are met by much
wailing and gnashing of teeth and heart-rending tales of vulnerable
insomniac residents.
On a wider scale, however, I wonder why it is worthy of comment that
patients who require nursing home care are on more medication than their
peers who are managing a more independant existence, and why this fact
should be taken as a sign of inadequate care. It was not even clear
whether we GPs are over-or-under prescribing. I am sure there are up-to-
date figures for the proportion of Care-of-Elderly admissions which are
iatrogenic, and if you wanted to draw up a rogues gallery of responsible
drugs, I am sure that beta-blockers and aspirin would not be left out.
I attempt, with very limited time, and against often competing
interests, to tailor my care to the individual circumstances of my
patients, and to resist the pressure to reduce them to a list of tick-
boxes. To take another swipe, it appears that if I wish to increase, or
even maintain my income if the New Contract does come in, that I will face
ever more such pressure.
Competing interests:
GP struggling with Nursing Home demands
Competing interests: No competing interests